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Management of the patient with eosinophilic asthma: a new era begins

Jantina C. de Groot, Anneke ten Brinke, Elisabeth H.D. Bel
ERJ Open Research 2015 1: 00024-2015; DOI: 10.1183/23120541.00024-2015
Jantina C. de Groot
1Department of Respiratory Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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  • For correspondence: Christa_de_groot@yahoo.com
Anneke ten Brinke
1Department of Respiratory Medicine, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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Elisabeth H.D. Bel
2Department of Respiratory Medicine, Amsterdam Medical Centre, Amsterdam, The Netherlands
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This article has a correction. Please see:

  • “Management of the patient with eosinophilic asthma: a new era begins” Jantina C. de Groot, Anneke ten Brinke and Elisabeth H.D. Bel. ERJ Open Res 2015; 1: 00024-2016. - July 01, 2016

Abstract

Now that it is generally accepted that asthma is a heterogeneous condition, phenotyping of asthma patients has become a mandatory part of the diagnostic workup of all patients who do not respond satisfactorily to standard therapy with inhaled corticosteroids. Late-onset eosinophilic asthma is currently one of the most well-defined asthma phenotypes and seems to have a different underlying pathobiology to classical childhood-onset, allergic asthma. Patients with this phenotype can be identified in the clinic by typical symptoms (few allergies and dyspnoea on exertion), typical lung function abnormalities (“fixed” airflow obstruction, reduced forced vital capacity and increased residual volume), typical comorbidities (nasal polyposis) and a good response to systemic corticosteroids. The definitive diagnosis is based on evidence of eosinophilia in bronchial biopsies or induced sputum, which can be estimated with reasonable accuracy by eosinophilia in peripheral blood. Until recently, patients with eosinophilic asthma had a very poor quality of life and many suffered from frequent severe exacerbations or were dependent on oral corticosteroids. Now, for the first time, novel biologicals targeting the eosinophil have become available that have been shown to be able to provide full control of this type of refractory asthma, and to become a safe and efficacious substitute for oral corticosteroids.

Abstract

Late-onset eosinophilic asthma has a distinct clinical and functional profile with treatment implications http://ow.ly/MH7AH

Footnotes

  • Disclosures can be found alongside this article at openres.ersjournals.com

  • Received May 5, 2015.
  • Accepted May 5, 2015.
  • Copyright ©ERS 2015

This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

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Management of the patient with eosinophilic asthma: a new era begins
Jantina C. de Groot, Anneke ten Brinke, Elisabeth H.D. Bel
ERJ Open Research May 2015, 1 (1) 00024-2015; DOI: 10.1183/23120541.00024-2015

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Management of the patient with eosinophilic asthma: a new era begins
Jantina C. de Groot, Anneke ten Brinke, Elisabeth H.D. Bel
ERJ Open Research May 2015, 1 (1) 00024-2015; DOI: 10.1183/23120541.00024-2015
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  • Article
    • Abstract
    • Abstract
    • Introduction
    • Asthma phenotypes and the role of the eosinophil
    • Molecular pathways of eosinophilic inflammation
    • Clinical profile of the patient with eosinophilic asthma
    • Management of the patient with eosinophilic asthma
    • New treatment options for the patient with eosinophilic asthma
    • Conclusions
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